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Mellor, S G; Thomas, M H; Donnellan, B S
doi: 10.1177/014107688808101005pmid: 3184087
The aim of this study was to determine whether drains influenced the size of subhepatic collections following cholecystectomy, and if these had any affect on complications.Eighty-five patients undergoing cholecystectomy had either no drain, a narrow bore suction drain or an open corrugated drain. Subhepatic fluid collections were measured by real time ultrasound on the first and fifth postoperative days, and thereafter if necessary. The volumes of fluid drained were also measured and clinical complications recorded. The subhepatic collections were, on average, the same whether a drain was used or not. Drains produced volumes considerably in excess of any subhepatic collection measured, but they did not appear to warn of biliary leakage. More complications (28%) were seen in the drained group compared with the undrained group (10.5%), and furthermore, the complications did not seem to occur in relation to the larger collections. One patient who had had a corrugated drain correctly placed developed biliary peritonitis.We suggest that drainage of simple cholecystectomy is unnecessary and, if an open drain is used, potentially dangerous.
doi: 10.1177/014107688808101006pmid: 3184088
A prospective study involving all casualty departments in Trent Region and 81% of the major eye units in UK was performed to determine ocular morbidity from the use of fireworks during 1986. A serious injury was defined as involving admission to hospital and/or intraocular damage. Of all the injuries from fireworks, 16.7% seen at major eye units were serious and were caused by rockets or exploding fireworks (P< 0.001). Only 53% of all injuries and 12.5% of serious injuries involved children, and in contrast to the 1950s and early 1960s, young adults appear at greatest risk in the 1980s. Legislation to reduce ocular morbidity should concentrate on restricting the use of rockets and exploding fireworks and encouraging the use of suitable eye protection.
doi: 10.1177/014107688808101007pmid: 3184089
Overuse syndrome, a condition of pain and loss of function in muscle groups and ligaments through excessive use, is common in musicians. In this series, the less serious cases of the disorder have been successfully treated by a modification of physical activity while allowing the musician to continue to play. The more serious cases were treated by a radical rest programme, first described last century, usually up to 12 months, until the patient is pain free and the muscles and ligaments are no longer tender. Performance is then very gradually resumed. The criterion for total success is a return to music performance free of pain with sustainable practice habits.
doi: 10.1177/014107688808101008pmid: 3184090
Eleven patients with the dystrophic form of epidermolysis bullosa underwent ophthalmic assessment to establish the presence, characteristics, and extent of any ocular involvement. Eight patients were found to have eye changes: these included varying degrees of Symblepharon, broadening of the limbus, and corneal opacities. Taken as a group, these changes formed a characteristic pattern. The majority of patients were asymptomatic and the ocular changes appear to be only slowly progressive. Recurrent corneal abrasion and Symblepharon are the most important complications.
Kuan, A K; Jackson, F I; Hanson, J
doi: 10.1177/014107688808101009pmid: 3054099
A retrospective evaluation of radionuclide liver and spleen scintigraphy (LS), ultrasonography (US), and computed tomography (CT) was performed in 88 patients who had pathologically proven cutaneous melanoma. In patients who had all three examinations (n=24), the matrix analysis showed that CT was significantly more sensitive (0.94) in detecting intra-abdominal metastasis when compared to US (0.62, P<0.05) and LS (0.38, P<0.01). Sixty-four patients had only US and LS studies. In this group of patients US was found to be more sensitive than LS, 0.88 and 0.54 respectively (P<0.01). Furthermore, when CT was compared with US, CT was shown to detect metastases significantly earlier than US (P=0.03). Overall, CT provided the most accurate means for detecting the intra-abdominal metastases of cutaneous melanoma.
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